Abstract:
Introduction: Despite the rapid development of clinical medicine, In the XXI century, nevertheless, a number of unresolved and problematic diseases remain. One of the most acute and global problem for modern medicine is hepatitis C. Georgia belongs to high prevalence countries of HCV. According to the latest epidemiological research conducted in the country, 7.7% of the country's population is positive for hepatitis C antibodies. The number of new cases of HCV infection in Georgian among children increases annually. The HCV is transmitted from mother to infant in 1 from 6 cases. Infections can occur through vertical transmission both during vaginal delivery and cesarean section. Host genetics is assumed to influence the outcomes of HCV infection, in both the abilities to achieve sustained viral response (SVR) after antiviral treatment and spontaneous clearance. The aim of this study was to assess the immunogenetic factors which influence the spontaneous clearance or Chronicle of HCV among infected youngsters.
Material and Methods: The Analysis of anti-HCV antibodies and HCV RNA have been performed to determine which form of HCV infection we were dealing with - spontaneously cured form or chronic infection. Study subjects were recruited from the retrospective case-control study of HCV infection in pediatric populations and the risk factors affecting the clinical course of HCV infection. The study involved children from different pediatric clinics and from different regions of Georgia. Data entry, verification, management and statistical analysis of the data obtained through the questionnaire were carried out by statistical package SPSS version 20. The χ2 (Chi-square) test or the Fisher`s exact test was used to determine the statistical significance of the associations between qualitative factors. We studied the polymorphism of the interleukin 28 (IL28) gene by real-time polymerase chain reaction (SACACE Biotechnologies IL28B rs17 / rs0 Real-TM PCR Kit, Como, Italy). This real-time PCR test allowed us to distinguish the following genetic variants: homozygous CC, TT, and heterozygous CT. At the data analysis stage, two groups of CC and non-CC were formed to group the functional variants, since the variant of protection against infection is predominantly the non-CC variant and it was important to compare it together with all other variants.
Results and their discussion:In our study the total number of children positive for HCV antibodies were 86. It was found that 39 of them (45.30%) had positive HCV PCR test result, while the remaining 41 (54.70%) had negative HCV PCR test result. Of the HCV PCR (+) children, the CC variant of the IL 28 gene was identifined in 19 (48.70%); Of the HCV PCR (-) children, the CC variant of the interleukin 28 gene was identifined in 13 (27.70%). Bivariate analysis showed that p = 0.04, the 95% confidence interval was [1,01; 6,17] and the mean odds ratio (OR) was 2.46.
Conclusion: Based on the study, for the first time in Georgia, the immunogenetic factor of clearance and chronicity of hepatitis C infection in children were studied and the importance of interleukin IL 28B polymorphism in the clinical course and outcome of HCV infection was documented.
